虚拟现实呼吸训练对颈髓损伤患者膈肌功能影响研究

Effect of virtual reality breathing training on diaphragm function in patients with cervical spinal cord injury

目的:探讨虚拟现实呼吸训练技术对颈髓损伤患者膈肌功能的影响。方法:57例颈髓损伤患者随机分为观察组28例和对照组29例,2组患者分别行常规呼吸功能训练(咳嗽训练、缩唇呼吸、腹式呼吸、沙袋加压抗阻训练训练),观察组在此基础上使用虚拟现实呼吸功能训练法。治疗前和治疗6周后分别观察2组患者的膈肌厚度、增厚率、移动度、膈神经传导速度和波幅变化。结果:治疗6周后,观察组增厚率和膈肌移动度较治疗前组内比较均明显提高(均P<0.05),观察组增厚率和膈肌移动度较对照组均明显提高(均P≤0.05);2组双侧波幅较治疗前均明显提高(均P<0.01),且观察组双侧波幅均明显高于对照组(均P<0.01);2组患者双侧膈神经运动传到速度组内和组间比较差异均无统计意义。结论:虚拟现实呼吸训练可有效提高颈髓损伤患者膈肌增厚率及移动度,提高患者膈肌电图波幅。

Objective:To investigate the effect of virtual reality breathing training technology on diaphragm function in patients with cervical spinal cord injury.Methods:A total of 57 patients with cervical spinal cord injury were randomly divided into treatment group(n=28)and control group(n=29)according to the order of visit.Patients in the two groups were given routine respiratory function training(cough training,lip contracting breathing,abdominal breathing,sandbag compression resistance training),and the treatment group was given virtual reality respiratory function training additionally.The changes of diaphragmatic muscle thickness,thickening rate,mobility,phrenic nerve conduction velocity and amplitude were observed before and after 6 weeks of treatment.Results:After 6 weeks of treatment,the thickening rate and diaphragm mobility in the treatment group were significantly increased as compared with those before treatment(both P<0.05),and those in the treatment group were significantly higher than those in the control group(both P≤0.05).The bilateral amplitudes of the two groups were significantly higher than before treatment(all P<0.01),and those of the treatment group were significantly higher than those of the control group(all P<0.01).There were no statistically significant differences in the speed of bilateral phrenic nerve transmission between the two groups.Conclusion:Virtual reality breathing training can effectively improve the diaphragmatic muscle thickening rate and mobility,and improve the diaphragmatic electromyography amplitude in patients with cervical spinal cord injury.